Hand, Foot, and Mouth in Children

WHAT IS HAND, FOOT AND MOUTH DISEASE?

Hand, Foot, and Mouth disease (HFMD) is a common viral illness caused by enteroviruses that predominantly affects children aged under 5 years. In the United States, outbreaks of HFMD typically occur during summer and autumn months. Hand, Foot and Mouth disease is often confused with foot-and-mouth disease (also called hoof-and-mouth disease), which affects cattle, sheep, and swine. However, the two diseases are caused by completely different viruses and are not related. Symptoms develop three to seven days after the initial infection has been contracted. This period is known as the incubation period. When symptoms do appear, you or your child may experience:

A fever and sore throat are usually the first symptoms of hand, foot, and mouth disease. The characteristic blisters and rashes show up later, usually one or two days after the fever begins.

Hand, Foot, and Mouth disease is often caused by a strain of coxsackievirus, most commonly coxsackievirus A16. The coxsackievirus is part of a group of viruses called enteroviruses. In some cases, other types of enteroviruses can cause Hand, Foot, and Mouth disease. Studies have shown that there are over 70 human enteroviruses and these affect millions of people worldwide each year, and are often found in the respiratory secretions (saliva, sputum, or nasal mucus) and stool of an infected person. In the past, poliomyelitis was the most prevalent disease caused by an enterovirus, the poliovirus. Now we know that there are over 60 non-polio enteroviruses that can cause disease in humans, including Hand, Foot and Mouth disease.

Viruses can be easily spread from person-to-person. You or your child may contract Hand, Foot, and Mouth disease through contact with an infected person’s:

saliva

fluid from blisters

feces

respiratory droplets sprayed into the air after coughing or sneezing

Hand, Foot, and Mouth disease can also be transmitted through direct contact with unwashed hands or a surface containing traces of the virus.

TREATMENT OF HAND, FOOT AND MOUTH DISEASE

Young children have the highest risk of contracting Hand, Foot and Mouth disease. Viruses can spread quickly in daycare facilities and schools that young children attend. Children will usually build up immunity to the disease after being exposed to the viruses that cause it and this is the reason it is not usually found in older children and adults. However, it’s still possible for older children and adults to get the infection, especially if they have weakened immune systems. Treatment for the disease is the same for children and adults. Hand, Foot and Mouth disease is a self-limiting disease which will run its course between seven and ten days. Since it is a virus, antibiotics will not be effective. There are over-the-counter medications that will help relieve the symptoms and just help you or your child feel a little better. These include:

topical ointments to help with blisters and the itchy rash

acetaminophen or ibuprofen (follow the dosage instructions on the package)

medicated lozenges or cough syrups to help with painful sore throats and coughs

avoid salty or spicy foods that may irritate the membranes in the mouth, also, avoid citrus drinks or fruits for the same reason

You or your child should feel completely better within five to ten days of onset. Because of the immunity built up after just one bout with the disease, re-infection is very uncommon.

PREVENTION OF HAND, FOOT AND MOUTH DISEASE

Good hygiene is the very best preventative measure to fight Hand, Foot and Mouth disease. Regular (and often) hand washing is paramount. Teaching your children to regularly wash their hands with warm water and soap will help prevent outbreaks. Hands should always be washed after using the bathroom, before eating and after being out in public. From the time they can understand what they are doing, babies and small children should be taught not to put their hands or other objects in or near their mouths. Get into the habit of disinfecting all common areas in your home on a regular basis. Clean shared surfaces with soap and water then spray or wipe with a diluted solution of bleach and water. Use this method to disinfect toys, pacifiers and other objects that may be contaminated with the virus. If you or your child come down with hand, foot and mouth disease, you should stay home from work or school to avoid contact with others. Stay away from the public until the blisters and rashes have cleared up and healed. This will prevent the spread to others.

OUTBREAKS OF HAND, FOOT AND MOUTH DISEASE

Large outbreaks of Hand, Foot, and Mouth disease are not common in the United States. However, in some countries in Asia, outbreaks are large and occur often. Thousands of people may get infected. Some people in Asian countries, especially young children, may have such severe symptoms of Hand, Foot and Mouth disease that they will require hospitalization. This disease has even caused death in children in some Asian countries. Travelers to these countries can protect themselves by being especially vigilant with good personal hygiene habits.

Over the last decade, many outbreaks of HFMD have been reported in countries of the Western Pacific Region, including Japan, Malaysia and Singapore, and across China. The incidence of Hand, Foot and Mouth disease appears to be increasing across the Region. Brunei, Korea, Taiwan and Viet Nam has also reported up swings in the incidence of the disease. This has prompted concerns that, without intervention, the public health impact and spread of the disease will continue to intensify.